Philip, Jerel Frederic

Philip, Jerel Frederic is an sole proprietor health care provider with primary practice located at 4100 Portola Dr Suite 1, Santa Cruz CA 95062. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Philip, Jerel Frederic can be contacted via phone (831) 475-7739.

Contact Information

Primary practice address
4100 Portola Dr Suite 1 Santa Cruz CA 95062
Phone: (831) 475-7739
Fax: (831) 475-7782
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 38159 California

Profile Details

NPI number 1720269947
LBN Legal business name Philip, Jerel Frederic
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 15th, 2007
Last updated Nov 15th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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